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William Henley shares how his first-day experience as a new English teacher influenced him to do everything in his power as a graduate student to mitigate the same first-day terror as a school librarian. He knew he had to get as much practical experience with school libraries as possible. These experiences added layers of invaluable context to what he gained from his courses in graduate school. In this article, Henley discusses what he learned from his engagement in practical experiences related to becoming a school librarian and provides suggestions for library science students, library science professors, and practicing school librarians.

Purpose: Oral corticosteroid (OCS) use for asthma is associated with considerable healthcare resource utilization (HCRU) and costs. However, no study has investigated this in relation to patterns of intermittent OCS prescription. Methods: This historical UK cohort study used primary care medical records, linked to Hospital Episode Statistics, from 2008 to 2019, of patients (≥ 4 years old) with asthma prescribed intermittent OCS. Patients were categorized by OCS prescribing pattern (one-off [single], less frequent [≥ 90-day gap] and frequent [< 90-day gap]) and matched 1:1 (by sex, age and index date) with people never prescribed OCS with/without asthma. HCRU (reported as episodes, except for length of hospital stay [days] and any prescription [records]) and associated costs were compared between intermittent OCS and non-OCS cohorts, and among intermittent OCS prescribing patterns. Results: Of 149,191 eligible patients, 50.3% had one-off, 27.4% less frequent, and 22.3% frequent intermittent OCS prescribing patterns. Annualized non-respiratory HCRU rates were greater in the intermittent OCS versus non-OCS cohorts for GP visits (5.93 vs 4.70 episodes, p < 0.0001), hospital admissions (0.24 vs 0.16 episodes, p < 0.0001), and length of stay (1.87 vs 1.58 days, p < 0.0001). In the intermittent OCS cohort, rates were highest in the frequent prescribing group for GP visits (7.49 episodes; p < 0.0001 vs one-off), length of stay (2.15 days; p < 0.0001) and any prescription including OCS (25.22 prescriptions; p < 0.0001). Mean per-patient non-respiratory related and all-cause HCRU-related costs were higher with intermittent OCS than no OCS (£ 3902 vs £ 2722 and £ 8623 vs £ 4929, respectively), as were mean annualized costs (£ 565 vs £ 313 and £ 1526 vs £ 634, respectively). A dose–response relationship existed; HCRU-related costs were highest in the frequent prescribing cohort (p < 0.0001). Conclusion: Intermittent OCS use and more frequent intermittent OCS prescription patterns were associated with increased HCRU and associated costs. Improved asthma management is needed to reduce reliance on intermittent OCS in primary care. [ABSTRACT FROM AUTHOR]

To investigate a unionid mussel die-off that began in 2016 in the Clinch River, organ tissues from 10 pheasantshells Actinonaias pectorosa (Conrad, 1834) were collected from Kyles Ford, TN, on October 6, 2016. Histological evaluations quantified abundances of tissue lesions in gills, digestive glands, and kidneys; gamete production and resorption levels in reproductive acini; and percentages of mussels infested with parasites. Atrophy and necrosis of digestive gland tissues were prevalent in most mussels, and pervasive necrosis in vesicular connective tissues (VCT) also was observed. Nine of the 10 mussels were infested with parasites. One mussel stained Gram positive, and examination revealed the presence of unidentified streptococci-like bacteria. Nine mussels stained Gram negative, and the stained spherical structures resembled cocci. High fractions of kidney cells containing lipofuscin were observed in the study mussels, indicating high levels of oxidative stress and probable impairment of important organ functions. It is likely that oxidative stress and consequent lipofuscin abundances in the kidney cells resulted from the combined effects of lesions (tissue damage, parasitic infestations, and presumptive bacterial infections) and the low-concentration contaminant array in the Clinch River. Necrosis in digestive glands and VCT decreased the available somatic energy (i.e., lipids and carbohydrates), although energy demands were high because of parasitic infestation, presumptive bacterial infection, altered physiological functions, and needed tissue repair. Although the results of this study could not determine the actual causes of mortality during the mussel die-off, they revealed numerous pervasive tissue lesions in the mussels, which led to starvation-like conditions due to unidentified environmental stressors. KEY WORDS: freshwater mussels, Actinonaias pectorosa, mussel die-off, histology, Clinch River, INTRODUCTION In 2016, a die-off of unionid mussels of unknown origin was observed at key mussel sites in the Clinch River, Hancock County, TN. During the die-off, mortality of multiple [...]

INTRODUCTION: iWHELD is a digital person‐centered care program for people with dementia in nursing homes adapted for remote delivery during the COVID‐19 pandemic. METHODS: A 16‐week two‐arm cluster‐randomized controlled trial in 149 UK nursing homes compared iWHELD with treatment as usual (TAU). Primary outcome was the overall quality of life with secondary outcomes of agitation and psychotropic use. RESULTS: iWHELD conferred benefit to quality of life on the primary (F = 4.3, p = 0.04) and secondary measures of quality of life (F = 6.45, p = 0.01) and reduced psychotropic medication use (χ2 = 4.08, p = 0.04) with no worsening of agitation. Benefit was seen in participants who contracted COVID‐19, those with agitation at baseline, and those taking psychotropic medications. DISCUSSION: iWHELD confers benefits to quality of life and key measures of well‐being, can be delivered during the challenging conditions of a pandemic, and should be considered for use alongside any emerging pharmacological treatment for neuropsychiatric symptoms. Highlights: iWHELD is the only remote, digital delivery nursing home training programme for dementia careiWHELD improved quality of life in people with dementia and reduced antipsychotic use without worsening of agitationResidents who contracted Covid‐19 during the study also experienced benefits from iWHELDiWHELD offers a valuable, pandemic‐safe tool for improving dementia care [ABSTRACT FROM AUTHOR]

ABSTRACT The North Fork Holston River (NFHR) historically supported 33 unionid mussel species downstream of Saltville, VA. Because of industrial contamination over decades from a chlor-alkali plant, a U.S. Environmental [...]